Department of Veterinary Medicine, The Queen's Veterinary School Hospital (QVSH), Madingley Road, Cambridgeshire, CB3 0ES, UK.
Vet Radiol Ultrasound. 2023 Jan;64(1):95-104. doi: 10.1111/vru.13143. Epub 2022 Aug 12.
Reherniation and reoperation rates of 4.5%-36% are reported in canine patients treated for intervertebral disc herniation (IVDH). Decision-making for surgical reintervention can prove challenging, especially since common postoperative changes are poorly described on MRI. The purpose of this single-center, retrospective, descriptive study was to describe the MRI characteristics of the surgical site in dogs treated for thoracolumbar IVDH and presenting for ongoing or recurrent neurological signs. Twenty-one patients were included for a total of 42 MRI studies. Chondrodystrophic breeds, specifically Dachshunds, were overrepresented. Mean number of days between surgery and second MRI was 335 (range 2-1367). Metallic susceptibility artifacts were seen in seven of 21 cases (33%), but these were limited in extent, spanning on average 1.3 vertebral bodies. In 11 cases, spinal cord compression suspected to be clinically significant was found at the surgical site; the extradural compressive material consisted of intervertebral disc material only, or a combination of intervertebral disc material and hematoma or inflammatory changes in 10 cases, and a displaced articular process and fibrous tissue in one case. The latter is a newly described complication of mini-hemilaminectomies. Paravertebral soft tissue changes and vertebral new bone formation varied according to the postoperative stage at which the patients were imaged. The results of this study supported the use of MRI as a diagnostic modality for spinal imaging following IVDH surgery, and showed that the presence of extradural disc material at a spinal surgical site is common along with various vertebral and paravertebral changes.
犬椎间盘突出症(IVDH)治疗后再突出和再手术的发生率为 4.5%-36%。手术再次干预的决策可能具有挑战性,尤其是因为 MRI 对常见的术后变化描述不佳。本单中心回顾性描述性研究的目的是描述接受胸腰椎 IVDH 治疗并出现持续或复发神经症状的犬的手术部位的 MRI 特征。21 例患者共纳入 42 项 MRI 研究。软骨发育不良品种,特别是腊肠犬,占比过高。手术和第二次 MRI 之间的平均天数为 335 天(范围 2-1367 天)。21 例中有 7 例(33%)出现 7 例金属敏感性伪影,但范围有限,平均跨越 1.3 个椎体。在 11 例中,在手术部位发现脊髓受压被怀疑具有临床意义;硬膜外压迫物质仅由椎间盘物质组成,或在 10 例中由椎间盘物质和血肿或炎症变化组成,在 1 例中由移位的关节突和纤维组织组成。后一种情况是微型半椎板切除术的一种新描述的并发症。椎旁软组织变化和椎体新骨形成根据患者接受 MRI 成像的术后阶段而有所不同。本研究结果支持 MRI 作为 IVDH 手术后脊柱成像的诊断方式,并表明在脊柱手术部位存在硬膜外椎间盘物质是常见的,同时伴有各种椎体和椎旁变化。